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Nursing Seniors Return from Clinical Rotation in Peru

05/09/2013

A particular group of senior nursing majors had been looking ahead to their finals weeks as Fisher students, which they would spend in Peru to complete their final clinical rotation. The group of 11 Wegmans School of Nursing students and two faculty took off on April 13 for a trip they now call “life and career-changing.”

The group traveled to the Sacred Valley of Peru and partnered with Sacred Valley Health, a non-governmental organization (NGO). As a region, Sacred Valley is full of opportunities for hiking adventures and visiting the Incan ruins. But as a high-altitude community, it lacks adequate health care facilities and personnel. According to Visiting Assistant Professor Tara Sacco, who accompanied the students on the trip, many of the individuals living in Sacred Valley ? and communities like it ? do not have access to care, clean water, or hygienic supplies. She said when someone is in need of care, they will often walk three or more hours to receive it from a local clinic.

“There are many challenges for this area and community health is a major focus,” she added.

On April 14, the group arrived in Cuzco, Peru, a large city approximately 12,000 feet above sea level. They were able to start their acclimation to the altitude while they were there, as well as adjust to the culture and language. The group also started to work on the community health projects they would be charged with while there.

From Cuzco, they traveled to Ollantaytambo, which would be the group’s home-base for the remaining two weeks. The first week, they were clinically focused on Promotora training. Promotoras are men and women elected by their communities to work as health aides. The students held training sessions in Ollantaytambo and Patacancha – both high-altitude communities. They set up stations focused on teaching CPR and Heimlich Maneuver; immediate care of fractures; immediate care of burns and wounds; and how to treat cough, diarrhea, vomiting (dehydration), hypothermia, and grave illness.

The second week focused on improving the health of the region’s children, which involved visits to primary schools to hold health fairs and informational sessions alongside the Promotoras. Sacco said this was the first time an initiative like this had been implemented. They had five stations that the children rotated through, including data collection (demographics, height, weight, and cavity count), toothbrushing, fluoride treatment, handwashing, and "Tippy Tap," a solution to handwashing when there is no running water available, creating a handwashing device made out of a stick, string, two water bottles, and soap. The group spent three days focused solely on the children, working with over 400 of them in that timeframe. Sacco said any health data and records they were able to collect from the children were also analyzed and will provide ongoing information for Sacred Valley Health to use in the future when planning such initiatives.

The group also had an opportunity to partner with another NGO, the Sacred Valley Project, which provides housing for teenage girls so they can receive a better education than they would in the higher- altitude communities. There were 10 girls staying in a dormitory in Ollantaytambo, and the Fisher group visited the dormitory, providing health education including toothbrushing, nutrition, and hygiene. Each girl received a gift bag that included shampoo, conditioner, soap, washcloths, toothbrushes, toothpaste, floss, and sanitary pads – donations from faculty, staff, and friends of the College. In addition, demographic and medical information was collected, and each girl received a physical.

“Each of these programs represents a sustainable effort to improve the healthcare in this region. The Promotora training is an ongoing project; new Promotoras in additional communities are brought in on a regular basis for training. We are incredibly proud to report that after each of the health fairs in the schools, the school administrators asked Sacred Valley Health to return for more education and screening for the children,” added Sacco.

Luckily for the students, it wasn’t all work and no play while in Peru. They also had an opportunity to visit Machu Picchu and the Salineras (Salt Flats), tag along on many hikes to explore the local ruins, and enjoy a horseback riding excursion.

Mackenzie White ’13 was part of the group. She was looking for a different kind of clinical experience to finish her undergraduate career, and wanted to experience a new culture at the same time.

She said her favorite part of the experience was the time they spent in the school with children teaching them personal hygiene and also screening them.

“They were so full of life and seemed to have a lot of fun with us. They could barely sit still they were so excited to go to each station,” she said.

White said now that she has gone abroad for a clinical rotation, she would recommend it for other nursing students.

“It makes you realize that there is life outside of Rochester, New York. There are so many other places to visit and cultures to learn about that we can’t even fathom. Doing a clinical experience abroad will allow you to learn so many new things and meet so many different people,” she said. “I may not have been in a hospital practicing my skills every day, but I have gained so much culturally. It is an important part to holistic care that is invaluable.”

Sacco and Visiting Assistant Professor Natalie Masco, the other faculty member who joined the group, said the trip did bring many challenges, including a language barrier, but that the impact the trip made on the Sacred Valley region, the students, and them personally is long-lasting.

“Students will be able to use this experience to shape their nursing careers in the future. Lessons in cultural acceptance, leadership and teamwork, and resource allocation, among others, were realized,” she said. “We hope to continue the relationship with Sacred Valley Health for senior preceptorship trips in the future.”

Mio Cantero ’13 had always wanted to go abroad, but has always yearned to participate in mission work outside of the United States. Knowing that the Peru trip was a once-in-a-lifetime opportunity, she took advantage of it.

She said the mornings were cold, but “glorious.” They had spectacular views from where they were staying, and while they started their mornings early, she said it was clear the people they were helping started their days even earlier. The group would arrive at the location they would be working that day, and there were people everywhere, waiting to be transported to their destinations, while store owners and market merchandisers were preparing for a day of business.

Cantero was also struck by the reaction of the schoolchildren upon the group’s arrival at the school.

“They were all so eager to see us and were receptive to the health education we provided,” she said.

She added that, besides putting her skills into practice, she very much enjoyed the people of the region, and learning their culture and traditions.

“I was amazed at how little they had, but at how freely they shared it. They had a very sound history that they proudly shared with outsiders. The ruins in every single mountainside told a story of where these people came from and why it has kept such a stronghold on their way of being. The family dynamic was very close-knit, where from the very young to the very old, everyone pitched in to ensure the survival and success of the entire family unit,” said Cantero. “This trip has profoundly impacted me and left me with a desire to pursue future global endeavors where volunteer nursing skills are needed.”

Students Tim Ford and Jill Brown teaching toothbrushing in Piscacucho during a school clinic.